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Medicare: My “Correspondence” With Eugene Robinson

Last week, Eugene Robinson, a columnist with the Washington Post who I used to read quite a bit of when he wrote for the Daily News here in New York, penned a column in which he repeated the President’s position that the Medicare cuts in the Affordable Care Act are not to benefits, merely to provider payments. After reading it, I sent him the following e-mail, entitled “Serious Medicare Question”:

Mr. Robinson,

I’m what you would probably call a swing independent; I’ve never voted Republican in a national election (mainly because I vehemently disagree with the party on social policy) but am registered independent and look at each election and each candidate on its and his own merits. After reading your column today (linked from RCP), and knowing that you are a serious man yourself, I am hoping you will provide a meaningful response to the following question:

I keep hearing the Democratic Party’s argument that the cuts to Medicare in the Affordable Care Act are not cuts to benefits, but merely to provider payments. And every time I do, I cannot help but agree with the Republican riposte: that cuts to provider payments – particularly cuts that the CBO says would render many Medicare providers, including 1 in 6 hospitals, non-profitable – are guaranteed to impact benefits by reducing access to care. Private providers facing such cuts in reimbursement rates – and a widening spread between Medicare reimbursements and other payments, along (likely) with rising overhead – are likely to either dramatically reduce the number of Medicare patients they see, stop taking Medicare entirely, or go the opposite route and become a business that looks to make up in volume what it lost in profit (resulting in less attentive, and therefore worse, care). What reason is there to believe any other outcome is possible?

And I’ll be honest. As a lawyer, the more I see people repeating the “it’s not a cut to benefits” line without addressing the argument that it is an indirect cut to access to and quality of care, the more convinced I am that there simply is no way to reasonably address that argument.

So I ask you, as a serious and well intentioned columnist who I know wouldn’t print an article he did not believe to be true: how do you address that Republican argument, such that you feel comfortable telling your readers that the Affordable Care Act cuts won’t impact benefits?